Contract Pharmacy Details

BIOSCRIP INFUSION SERVICES, LLC
DSH180029 HAZARD ARH REGIONAL MEDICAL CENTER

Covered Entity Details

Entity Name

HAZARD ARH REGIONAL MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH180029

Entity Address

100 MEDICAL CENTER DRIVE
HAZARD, KY 41701

Medicare Provider Number

180029

Participating Start Date

10/1/2004

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

BIOSCRIP INFUSION SERVICES, LLC

Pharmacy Address

DBA BIOSCRIP INFUSION SERVICES
4401 MACCORKLE AVE SE
CHARLESTON, WV 25304

Pharmacy Comments

Contract Details

Approval Date

7/14/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/24/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Joseph Grossman, PRESIDENT and CEO
(859) 226-2450

Contract Pharmacy Representative

Angie Christian, General Manager
(304) 414-3660

Signed By Date

7/14/2015

340B Drug Pricing Program Database